dr rongsheng cai supplier

There is a star rating of 4/5 for Dr. Rongsheng Cai, MD. Patients say that they trusted the provider"s decisions and the provider explained conditions well. See all patient feedback on Sharecare.

Dr. Rongsheng Cai is a Neurosurgery Specialist in Tulsa, Oklahoma. He graduated with honors in 1985. Having more than 38 years of diverse experiences, especially in NEUROSURGERY, Dr. Rongsheng Cai affiliates with no hospital, cooperates with many other doctors and specialists in medical group University Of Arkansas. Call Dr. Rongsheng Cai on phone number (918) 494-1710 for more information and advice or to book an appointment.

This doctor profile was extracted from the dataset publicized on Feb 1st, 2018 by the Centers for Medicare and Medicaid Services (CMS) and from the corresponded NPI record updated on Jun 2nd, 2020 on NPPES website. If you found out anything that is incorrect and want to change it, please follow this Update Dataguide.

Dr. Rongsheng Cai M.D. is a male health care provider in Tulsa with Neurological Surgeon listed as his primary medical specialization. His credentials are: M.D. (Doctor of Medicine). Dr. Rongsheng Cai M.D."s practice location is: 6151 S Yale Ave Ste 2403 Tulsa, OK 74136-1907.

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Drug costs accounted for 97.82% and 23.33% of the total direct medical expenditure for outpatients and inpatients at PUTH, respectively. Drugs for managing PD accounted for 60.48% and 2.70% for outpatient and inpatient drug costs, respectively, while medications for managing complications of PD weighted a smaller proportion. Of the drugs for managing PD, levodopa/benserazide and selegiline incurred the highest utilization (DDDs). In contrast, pramipexole and entacapone incurred the highest average daily costs (DDDc and LEDc) and average costs per outpatient visit or inpatient admission episode. A slightly and gradually decreasing trend was found in the drug cost per visit or admission episode over the calendar years.

In contrast, previous literature has reported that medicine costs account for 27.34% of total expenses for PD outpatients and inpatients enrolled in the U.S. Medicare population (10). However, the differences of drug-related economic burden for PD patients between the U.S. and China need more research. In a recent study, Liet al.[2021] found that the weight of drug costs (75.83%), diagnosis (21.84%), and medical service (1.42%) for medical cost of managing early PD patients (Hoehn-Yahr 1-2) differed from the weight of diagnosis (97.08%) and medical services (0.28%) for the medical cost of managing advanced PD patients (Hoehn-Yahr 3-5) in China (8). In our study, diagnostic costs accounted for a relatively smaller proportion, while drug costs were higher. Besides, drug costs accounted for 97.82% of the total costs for outpatients and 23.33% for inpatients, which are higher than the results of studies from Singapore and Metro Manila (11,15). This may be due to the relatively low acquisition cost for other treatment services in China during the study period.

Consistent with previous research (16), we found that levodopa/benserazide was the most frequently prescribed drug of the eight medicines for PD. The Chinese Guidelines for Anti-Parkinson’s Disease (third edition) and the latest edition (fourth edition) both recommend levodopa as the priority for early PD patients (Hoehn-Yahr 1-2.5) (2,17). Besides, McIntosh et al.found that initial treatment with levodopa is highly cost-effective compared with levodopa-sparing therapies, which is similar to our results (18). Drugs with higher costs per visit or admission episode, such as pramipexole, entacapone, and selegiline, may be attributed to their higher unit price.

Direct medical costs, especially drug costs, decline gradually as it is widely recognized that drug policies impact direct medical costs. Owing to the elimination of the additional drug mark-up in public hospitals called zero mark-up drug policy (ZMDP), implemented on 1 April 2017 in Beijing, the price of most medicines has dropped, especially for high-priced medications. However, because of their low price and shortages, trihexyphenidyl and amantadine have had their prices rise to guarantee their supply 1 to 2 months after ZMDP. Several studies have indicated that ZMDP reduces direct medical costs of patients, especially drug costs (20-23). Nevertheless, Yan et al. [2020] drew inconsistent conclusions (24) due to differences in geographical areas, medical institution levels, and diseases among studies. Thus, it is necessary to continuously monitor the impact of policies, dynamically adjust the prices of medical services, and implement the corresponding policy interventions (25).

This study had several strengths. Firstly, from the perspective of medical service providers, combined with the work experience of hospital pharmacists, our study was even closer to the reality of clinical practice. Secondly, the data source was the electronic medical record of PUTH, which might have improved the accuracy of results and connected diagnosis and medications well. Thirdly, we compared daily dose costs, levodopa equivalent dose costs, and average costs of 8 commonly used drugs for PD, providing a basis for research on prescribing patterns and pharmacoeconomics.

Our study also had several limitations that need to be addressed in further studies. Firstly, as a single-center study, the study sample may have selection bias. Therefore, the sample’s representativeness and the credibility of this study’s conclusions need to be fully validated. Further multi-center research will be carried out to evaluate the costs of PD in a broader population. Secondly, this study was conducted retrospectively, in which information of the stages of PD was not available when complication costs were related to the severity of PD. Thus, cohort studies in which patients will be followed up are suggested to enhance understanding of disease burden in different stages. Thirdly, the portions covered by the medical insurance differed among PD patients. Medical cost only accounts for a small portion of the total cost for chronic neuropsychiatric conditions, while caregiving such as nursing workers’ fee is costly. However, the data was not available in the electronic medical records from the hospital. Thus, we took the healthcare provider’s perspective in which the portions covered by the medical insurance and costs for caregiving were not usually considered. It is recommended that further research collect the information about health insurance and caregiving costs more comprehensively to improve the research.

Electronic databases, including PubMed, Embase and Chinese National Knowledge Infrastructure (CNKI), were searched to identify patient management research in major public health emergencies. Specific search strategies were developed for each database. Keywords including severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), H1N1 influenza, Ebola, Zika, COVID-19, patient management, health care management, patient administration, and patient care were used to search the title and abstract of the literature.

Designed to help specialist doctors and nurses provide better patient management in the COVID-19 period, 11 studies (20–30) have been researched and published, involving patients with malignancy, stoma, peritoneal dialysis, chronic viral hepatitis, elderly diabetes, hypertension and pregnant women. Most studies recommend timely diagnosis and referral and quarantine, telemedicine services including online monitoring and regimen adjustment and follow-up, and other targeted management measures. One study explicitly mentions the role of pharmacists, while there are some management measures related to pharmacist involvement in some of the included studies, including establishing medication files, providing medication guidance, monitoring adverse reactions of chemotherapy, implementing long-term prescriptions, and providing drug delivery and other services. The evidence table of studies about patient management of clinical specialties in the era of COVID-19 is summarized in Table 1.

In the situation of COVID-19, pharmacists should give full play to the role of public health management while providing pharmaceutical care combined with the pandemic. A patient-centered and integrated patient management strategy was researched and established, which covers the entire process, including home quarantine, outpatient visits and hospitalization. See Figure 4 for further details. Notably, regular pharmaceutical care (drug supply guarantee, rational medication guidance, MTM, etc.) as well as public health services (risk monitoring guidance, sanitation measures education, health management guidance, etc.) are attached equal importance in this strategy.

Currently, since most potential drugs for COVID-19 are still in clinical trials, pharmacists should ensure patients not to use drugs on their own following the treatment protocols from unidentified network sources. Pharmacists should provide home-based pharmaceutical care as follows (6): (1) Drug knowledge education. Pharmacists should provide helpful information about the identification of drugs and supplements, identification of prescription and non-prescription drugs, drug preservation, and drug instruction reading. (2) Rational medication guidance. Pharmacists should provide guidance on usage and dosage, dose adjustment for specific populations, and drug interactions (such as cephalosporin and alcohol, lipid-lowering drugs and grapefruit). (3) Medication management. To improve patients" medication compliance, pharmacists should assist patients, especially those with long-term medications, to establish a self-medication therapy record, which shall include basic information, long-term medication plans, and health supplements, temporary medications, monitoring of health indicators, monitoring of discomfort or adverse reactions, etc.

Outpatient visits are the first line of the health care system in a hospital, and outpatient management is crucial to the entire hospital management system. During the pandemic, in addition to actively participating in the control of in-hospital infections, pharmacists should provide outpatients with more targeted and high-quality patient management, including physician-pharmacist joint clinics, pharmacy clinics, medication therapy management (MTM), medication consultations, drug supply guarantee, and outpatient dispensing services.

When providing pharmacy clinic services, pharmacists should pay attention to patients" epidemiological investigations and symptom monitoring. Since no effective drug has been proved, pharmacists should provide non-pharmaceutical strategies for COVID-19 prevention to patients. Pharmacists should guide patients to understand the epidemic reasonably and take sufficient measures of personal protection while avoiding unreasonable preventive medication or excessive panic. Meanwhile, medication guidance and medication compliance should be strengthened, especially for patients with hypertension, lipid disorders, coronary heart disease, diabetes, asthma and other chronic diseases. These measures can promote safe and rational medication and long-term symptom control and help to reduce the frequency of hospital visits and the risk of COVID-19 infection.

Pharmacists should make full use of mobile apps and social media (WeChat and Facebook), phones, texts and other tools to provide online consultations (37). In addition to regular medication guidance, pharmacists should also provide scientific information about COVID-19, including mask wearing, hand hygiene, preparation process of alcohol-containing hand disinfectant, home cleaning and disinfection, and other protective measures. Notably, pharmacists should ensure that patients seek timely medical treatment when COVID-19 infection is suspected and not take drugs on their own following unconfirmed information.

During the epidemic, drug supply guarantee is one of the most essential responsibilities of pharmacists (38). For the medical treatment of infected cases, the demand for drugs is urgent and concentrated. Timely, orderly and reasonable drug supply guarantee is of great significance in promoting clinical treatment, promoting epidemic control, and maintaining social stability. Pharmacists should be designated to take charge of the purchase, storage, and distribution of key therapeutic drugs. The appointed pharmacists should adjust the inventory in a timely manner to meet the clinical demand. Key drugs involve antiviral drugs, immunomodulatory drugs, glucocorticoids, antimicrobials, vasoactive drugs, and intestinal micro-ecological regulators, as well as Chinese patent medicine and Chinese herbal medicine (4, 39, 40).

When dispensing drugs, pharmacists should provide personal protection and other COVID-19-related information through oral education and poster displays. Pharmacists should open dispensing windows at intervals to avoid patients gathering and ensure that patients are in line to keep a safe distance (41). Meanwhile, to reduce the frequency of hospital visits, a series of special medical insurance policies have been issued, including extending the time length of prescription and medical insurance of telemedicine. Therefore, pharmacists should strengthen medication instructions and ensure that patients take drugs with doctor advice. Combined with telemedicine, patients can provide home delivery of drugs by express. In addition, pharmacists should encourage patients in various ways to maintain a good mentality and confidence in overcoming the epidemic, such as writing encouraging texts in patient education materials.

Confirmed cases need to be admitted to COVID-19-designated hospitals for further inpatient treatment. First, most potential drugs for COVID-19 are still in clinical trials with uncertain safety and efficacy. Second, lopinavir/ritonavir and other antiviral drugs have complicated drug interactions. In addition, some patients may quickly progress to severe or critical condition, with acute respiratory distress syndrome (ARDS), sepsis, and multiple organ dysfunction, particularly in patients with complicated underlying diseases (diabetes, hypertension, cardiovascular disease, malignancy, etc.) (42, 43). Therefore, it is necessary for pharmacists to provide targeted pharmaceutical care for COVID-19 inpatients, including participating in making evidence-based decisions for medication, monitoring and evaluating the safety and efficacy of medications, providing drug interactions management, providing strengthened care for special populations and patients with combined underlying diseases, monitoring and management of convalescent plasma therapy (CPT) and so on (44).

Based on the evidence-based review of patient management research in major public health emergencies, combined with the practical strategy of Chinese pharmacist management during the COVID-19 period, recommendations were formulated for pharmacists. Regarding the home quarantine period, pharmacist management services shall include medication guidance, guidance on risk monitoring, sanitation measures education, health management guidance and psychological support. Regarding the outpatient visit period, pharmacists should participate in the control of in-hospital infections and provide physician-pharmacist joint clinic services, pharmacy clinic services, medication therapy management, medication consultation services, drug supply guarantee and drug dispensing services. Regarding the hospitalization period, pharmacist management services should include monitoring and evaluating the safety and efficacy of medications, providing strengthened care for special populations and other pharmaceutical care. For non-hospitalized or discharged patients, pharmacist management services should include formulating medication material, conducting telephone follow-up, and establishing pharmacy management files.

To the best of our knowledge, there have not been any previous studies addressing the management strategy of the public and patients from pharmacists" perspective in the era of COVID-19. Compared with published patient management studies (7–26, 28–30) focusing mostly on doctors and nurses, the current study emphasizes the indispensable role of pharmacists in patient management, exposing and remedying the gaps in the existing patient management. Compared with existing studies on pharmaceutical care, a previous mapping review by our study team (46) demonstrated that the existing studies mostly focused on some specific aspects of pharmaceutical services, such as drug supply, infection control of pharmacists, and online pharmaceutical services. To a certain extent, the existing studies lacked sufficient details to implement patient management for pharmacists in daily work. Overall, the strategy of pharmacist management linked to current clinical management has not yet been established.

Therefore, combining the existing patient management mode, the present study formulated fresh measures of pharmacist management. Pharmacist management measures in key links were strengthened, including prehospital home quarantine, hospitalized medical treatment and follow-up after discharge. Finally, a patient-centered and multidisciplinary-involved strategy of patient management was established and can be put into practice. A previous study illustrated the paradigm shift of drug information centers during the COVID-19 pandemic (47). It emphasized the pharmacists" role in providing information for the public on home care, medication management of patients with chronic comorbid illnesses and psychological support, which were consistent with the present study. Besides, an additional strategy of entire-process management, especially for inpatients and outpatients, was stressed in our study. Similar to our original intention, a previous study partially summarized China"s approaches to the control of COVID-19, which pharmacists worldwide can learn from (48).

ZS and RZ conceived this manuscript and performed the manuscript frame. ZS and YH identified reports of included studies and extracted data. ZS, YH, ZR, GW, and SL performed all statistical analyses, checked for statistical inconsistency, and interpreted the data. ZS and YH drafted the report. SZ, LY, and RZ critically reviewed the manuscript. All authors approved the submitted version.

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36. Pellegrino AN, Martin MT, Tilton JJ, Touchette DR. Medication therapy management services: definitions and outcomes. Drugs. (2009) 69:393–406. doi: 10.2165/00003495-200969040-00001

38. Chin TW, Chant C, Tanzini R, Wells J. Severe acute respiratory syndrome (SARS): the pharmacist"s role. Pharmacotherapy. (2004) 24:705–12. doi: 10.1592/phco.24.8.705.36063

41. Sun ZY, Song ZW, Cai Z, Zhao RS. Emergency management strategies for hospital outpatient pharmacy during the coronavirus disease 2019 epidemic based on the 4M1E methods. Chin Pharm. (2020) 29:44–6. doi: 10.3969/j/issn.1006-4931.2020.06.011

43. Wu CM, Chen XY, Cai YP, Xia JA, Zhou X, Xu S, et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Intern Med. (2020) 180:934–43. doi: 10.1001/jamainternmed.2020.0994

47. Khatiwada AP, Shakya S, Shrestha S. Paradigm shift of drug information centers during the COVID-19 pandemic. Drugs Ther Perspect. (2020) 36:389–95. doi: 10.1007/s40267-020-00757-3

49. Shrestha S, Khatri J, Shakya S, Dabejhu K, Khatiwada AP, Sah R, et al. Adverse events related to COVID-19 vaccines: the need to strengthen pharmacovigilance monitoring systems. Drugs Ther Perspect. (2021) 37:376–82. doi: 10.1007/s40267-021-00852-z